Nearly one-fourth of all trauma admissions present in varying degrees of coagulopathy. According to a US study, 40% of trauma fatalities are due to hemorrhage and hemorrhagic shock, and nearly all patients who are alive when they reach the hospital are coagulopathic when they die. Once coagulopathy develops, patient morbidity drastically increases. Because of the clinical significance of trauma-induced coagulopathy, management strategies to reduce the morbidity and mortality have recently become of interest. This article will review the pathology of trauma-induced coagulopathy and current trends in management, as well as closely examine the data surrounding the use of recombinant factor VII for the treatment of trauma-induced coagulopathy.